The Future of the WHO—and How the United States Can Shape It

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The United States is on the brink of withdrawing from the World Health Organization (WHO), but this decision marks not an end, but a beginning. The world of global health is evolving, and this shift presents an opportunity to reshape the future of health governance on the global stage. The U.S. departure from the WHO could have far-reaching consequences, not just for Americans, but for the entire world. While the decision may seem like a break from multilateralism, it’s a crucial moment for recalibrating how the U.S. engages with global health institutions.

Understanding the U.S. Withdrawal from the WHO

In a dramatic policy shift, President Trump issued an executive order in January 2025, signaling the end of the U.S.’s formal relationship with the World Health Organization. As the process of withdrawal continues, it serves as a powerful reminder of the political tensions surrounding multilateral health organizations. The withdrawal, following a prolonged period of U.S. dissatisfaction with the WHO’s handling of the COVID-19 pandemic, has generated substantial debate about the effectiveness of such global institutions.

The decision to leave the WHO stems from several factors:

• Frustration with the WHO’s Response to the Pandemic: Many critics argue that the WHO was too slow to respond to the global COVID-19 crisis and that its initial alignment with China undermined its credibility.
• Concerns Over WHO Leadership: The leadership of Director-General Dr. Tedros Adhanom Ghebreyesus has faced intense scrutiny, particularly regarding his relationship with China.
• A Broader Shift Toward Nationalism: The U.S. administration’s broader “America First” stance has called into question the effectiveness of multilateral institutions, including the WHO, in addressing global health challenges.

However, while the United States may leave the organization for now, this article posits that this decision is not irreversible. The U.S. still holds significant stakes in the future of global health governance.

What Comes After the U.S. Withdrawal?

The United States will not withdraw from global health—it will simply reframe its approach. The question now is: how can the U.S. shape the future of the WHO and international health policy without compromising its interests?

Here’s a roadmap for U.S. engagement:

1. Rebuilding U.S. Influence within Global Health Governance

Although the U.S. is pulling out of the WHO, it remains a critical player in the global health landscape. One of the first steps for the U.S. post-withdrawal should be a strategy to influence the selection of the next WHO Director-General. The selection of a new leader in 2027 will be pivotal, and the U.S. must push for a candidate who can commit to necessary reforms while prioritizing the values and goals aligned with American interests.

The Path Forward:

• Engage Diplomatically: The U.S. must work closely with its allies, particularly from emerging economies such as Saudi Arabia, Qatar, Indonesia, and Brazil, to form a consensus around a candidate who understands the need for reform in the WHO.
• Prevent Dominance by China and Russia: Left unchecked, these nations could push for a WHO leader who favors their own political agendas. U.S. engagement will be crucial in ensuring a more balanced, reform-oriented selection process.

2. Defining the Next Reform Agenda for the WHO

With its decision to withdraw, the Trump administration has effectively created leverage to demand reforms within the WHO. However, to maximize this opportunity, the U.S. must clearly articulate what specific reforms it seeks. Key areas for reform include:

• Transparency and Efficiency: Streamlining the WHO’s bureaucratic processes and increasing the speed at which new medical products and treatments are approved.
• Global Health Surveillance: Strengthening the WHO’s capacity to monitor and respond to health crises, especially in regions with limited oversight.
• Improved Cooperation with U.S. Biopharma: Modernizing the WHO’s prequalification process to better support U.S. pharmaceutical and medical manufacturers who play a crucial role in global health.

In recent years, the WHO has taken steps toward reform, such as reducing its budget and workforce. These moves have been seen as positive, but they are just the beginning. Further action is required to ensure the organization can meet the challenges of the next decade.

3. Enhancing U.S. Bilateral Health Agreements

Even as it steps back from the WHO, the U.S. should continue fostering bilateral health agreements, particularly in low- and middle-income countries where the WHO has the most influence. The U.S. should look to enhance its global health strategy by:

• Supporting Regional Partnerships: Strengthening collaborations with over 70 countries to enhance surveillance, response to outbreaks, and health infrastructure.
• Empowering CDC Offices: Increasing U.S. presence in key regions with CDC offices and other health attachés to bolster national and regional health security.

These bilateral agreements, while important, cannot replace the WHO’s global reach and capabilities. It is crucial that the U.S. maintains a strong, positive relationship with the organization, particularly for outbreaks that cross borders and affect global health.

4. Restoring U.S. Funding and Leadership within the WHO

The U.S. must consider the long-term goal of rejoining the WHO under better terms. Congress should lay the groundwork for this by signaling its intent to restore funding for the WHO in exchange for meaningful reforms. This would not only demonstrate the U.S.’s commitment to global health leadership but also ensure that the WHO is better equipped to address future health emergencies.

Key Actions:

• Linking Funding to Reform: Any future U.S. funding should be tied to concrete reforms in WHO operations and governance.
• Preparing for U.S. Re-engagement: As the U.S. approaches the potential restoration of its membership in 2027, it should begin a process of engagement with WHO members and leadership to ensure a smooth transition.
  
  

Conclusion: A Global Health System Reimagined

The United States’ exit from the WHO is not the final chapter in its relationship with global health. In fact, it’s the beginning of a critical period of reflection and reform. While this decision has raised questions about the future of multilateralism, it also offers a unique opportunity to reshape the global health system in a way that better aligns with U.S. priorities and values.

The path forward requires a thoughtful, strategic approach that balances U.S. interests with global health needs. By carefully engaging with international partners, driving reform within the WHO, and strengthening bilateral health agreements, the U.S. can help shape a more effective and responsive global health system for the future.

Author Profile

Syed Tahir Abbas Shah

Syed Tahir Abbas is a Master's student at Southwest University, Chongqing, specializing in international relations and sustainable development. His research focuses on U.S.-China diplomacy, global geopolitics, and the role of education in shaping international policies. Syed has contributed to academic discussions on political dynamics, economic growth, and sustainable energy, aiming to offer fresh insights into global affairs.

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